The impact of timing of insemination in relation to ovulation on the cycle pregnancy rate of intrauterine insemination and intrauterine tuboperitoneal insemination in unexplained infertility

Elkholi, Dina Gamal Eldeen Y.; Nagy, Halah Mohamed

doi:10.1016/j.mefs.2015.03.001

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…Of the remaining 375 papers, 117 did not classify a definition of unexplained infertility. As a result, a total of 258 primary research papers with full text available were included …”

Section: Resultsmentioning

confidence: 99%

The definition of unexplained infertility: A systematic review

Raperport,

Desai,

Qureshi

et al. 2023

BJOG

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BackgroundThere is no consensus on tests required to either diagnose unexplained infertility or use for research inclusion criteria. This leads to heterogeneity and bias affecting meta‐analysis and best practice advice.ObjectivesThis systematic review analyses the variability of inclusion criteria applied to couples with unexplained infertility. We propose standardised criteria for use both in future research studies and clinical diagnosis.Search strategyCINAHL and MEDLINE online databases were searched up to November 2022 for all published studies recruiting couples with unexplained infertility, available in full text in the English language.Data collection and analysisData were collected in an Excel spreadsheet. Results were analysed per category and methodology or reference range.Main resultsOf 375 relevant studies, only 258 defined their inclusion criteria. The most commonly applied inclusion criteria were semen analysis, tubal patency and assessment of ovulation in 220 (85%), 232 (90%), 205 (79.5%) respectively. Only 87/220 (39.5%) studies reporting semen analysis used the World Health Organization (WHO) limits. Tubal patency was accepted if bilateral in 145/232 (62.5%) and if unilateral in 24/232 (10.3%). Ovulation was assessed using mid‐luteal serum progesterone in 115/205 (56.1%) and by a history of regular cycles in 87/205 (42.4%). Other criteria, including uterine cavity assessment and hormone profile, were applied in less than 50% of included studies.ConclusionsThis review highlights the heterogeneity among studied populations with unexplained infertility. Development and application of internationally accepted criteria will improve the quality of research and future clinical care.

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“…Of the remaining 375 papers, 117 did not classify a definition of unexplained infertility. As a result, a total of 258 primary research papers with full text available were included …”

Section: Resultsmentioning

confidence: 99%

The definition of unexplained infertility: A systematic review

Raperport,

Desai,

Qureshi

et al. 2023

BJOG

View full text Add to dashboard Cite

show abstract

“…The clinical outcomes following IUI are influenced by many factors, including age, infertility type, sperm quality, mature follicular number, and endometrial thickness among other factors ( 24 – 28 ). Herein, the age of males was negatively associated with the clinical pregnancy and live birth in this study, indicating that it also plays a key role in clinical outcomes in patients with infertility attributed to unexplained or mild male factors ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis: The application of human menopausal gonadotropin combined with letrozole for IUI in patients undergoing artificial insemination by husband due to unexplained or mild male factors

Pan

et al. 2022

Front. Endocrinol.

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ObjectiveTo compare the effects of human menopausal gonadotropin (HMG) combined with letrozole (LE) to HMG only for ovarian stimulation on pregnancy outcome of infertile patients undergoing artificial insemination by husband (AIH) due to unexplained or mild male factors.Materials and methodsInfertile patients with unexplained or mild male factors treated from July 2015 to December 2021 were selected as subjects. The patients were divided into two groups according to the ovarian stimulation schemes they received, namely HMG combined with LE or HMG only. We analyzed the laboratory examination results before drug treatment (baseline) and during ovarian stimulation and compared the pregnancy outcomes of the two groups using univariable analysis and multivariable logistic regression analysis.ResultsIn total, 526 cycles of 372 couples were included. The univariate analysis showed that the clinical pregnancy rate of the HMG combined with LE group was 24.8%, significantly higher than that of the HMG group (14.8%, P = 0.007). The live birth rate (19.9%) of the HMG combined with LE group were also significantly higher than those of the HMG group (11.2%, respectively). In multivariate logistic analysis, the age of males was negatively associated with the clinical pregnancy rate (OR 0.874, 95% CI 0.793~0.963, P=0.006) and live birth (OR0.875, 95% CI 0.783~0.977, P=0.018). Moreover, ovarian stimulation with HMG+LE was the only beneficial factor significantly associated with clinical pregnancy (OR 1.929, 95% CI 1.068~3.485, P=0.029) and live birth (OR 2.255, 95% CI 1.188~4.282, P=0.013).ConclusionOvarian stimulation using HMG combined with LE can increase the clinical outcomes (live birth and clinical pregnancy) among infertile patients undergoing AIH due to explained or mild male factors.

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“…It can be classified into artificial insemination by husband (AIH) and artificial insemination by donor (AID) according to the source of the sperm. There are many factors influencing the clinical pregnancy rate following IUI, including age, infertility type, sperm quality, mature follicular number, endometrial thickness, and so on (3)(4)(5)(6)(7). However, the prognostic values of these factors remain controversial.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Prognostic Factors for Clinical Pregnancy Rate Following Artificial Insemination by Husband in the Chinese Population

Luo

Yuan

et al. 2021

Front. Med.

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Background: To determine the independent prognostic factors and develop a multivariate logistic regression model for predicting successful pregnancy following artificial insemination by husband (AIH) in infertile Chinese couples.Methods: A total of 3,015 AIH cycles with superovulation from 1,853 infertile Chinese couples were retrospectively analyzed. The clinical characteristics and sperm parameters were compared between the pregnant and non-pregnant groups. Multivariate logistic regression analysis was performed to remove the confounding factors and create an equation to predict the successful pregnancy. Receiver operating characteristic (ROC) curves were constructed for evaluating the abilities for prognostic classification of the independent predictors and the equation.Results: The overall pregnancy rate was 13.0%. The pregnancy rate of double intrauterine insemination (IUI) (18.9%) was significantly higher than that of single IUI (11.4%). The pregnancy rate of the stimulated cycle (14.4%) was significantly higher than that of the natural cycle (9.0%). The pregnancy rates of the age groups <40 years are ~3 times higher than that of the ≥40 years age group. Among sperm parameters, the influencing factors included straight-line velocity (VSL), sperm deformity index (SDI), and normal form rate (all P < 0.05). A multivariate logistic regression equation was created based on the above influencing factors. ROC analysis showed that the prognostic power of the equation is better than those of individual predictors.Conclusion: Cycle treatment options, single/double IUI, female age, sperm VSL, SDI, and normal form rate could predict successful pregnancy following AIH in China. The multivariate logistic regression equation exhibited a greater value for prognostic classification than single predictors.

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The impact of timing of insemination in relation to ovulation on the cycle pregnancy rate of intrauterine insemination and intrauterine tuboperitoneal insemination in unexplained infertility

Cited by 3 publications

References 28 publications

The definition of unexplained infertility: A systematic review

The definition of unexplained infertility: A systematic review

Retrospective analysis: The application of human menopausal gonadotropin combined with letrozole for IUI in patients undergoing artificial insemination by husband due to unexplained or mild male factors

Evaluation of Prognostic Factors for Clinical Pregnancy Rate Following Artificial Insemination by Husband in the Chinese Population

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